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ILHIE Medicaid Work Group Minutes - March 21 2011 

March 21, 2011

Attendees (phone and in-person):

  • Amanda Attaway, Illinois State Medical Society
  • Dave Barnes, Department of Healthcare and Family Services (HFS)
  • Janet Barrett, OSF Healthcare
  • Julie Bonello, Access Community Health Network
  • Pat Borrowdale, Pediatric Health Associates
  • Kelly Carter, Illinois Primary Health Care Association
  • Connie Christen, HFS
  • Andrew Garrett, HFS
  • Krysta Heaney, Office of Health Information Technology (OHIT)
  • Roger Holloway, Illinois Health Information Technology Regional Extension Center (IL-HITREC)
  • Peter Ingram, Sinai Health System
  • Vince Keenan, Illinois Academy of Family Physicians
  • Mike Koetting, HFS
  • Frank Kopel, HFS
  • Stan Krok, Children's Memorial Hospital
  • John Lekich, HFS
  • Lisa Lenc, Children's Memorial Hospital
  • Mary McGinnis, OHIT
  • Elizabeth McKnight, Chicago Health Information Technology Regional Extension Center (CHITREC)
  • Susan Melczer, Metropolitan Chicago Healthcare Council
  • Renee Perry, HFS
  • Mary Ring, Illinois Critical Access Hospital Network
  • Katherine Sherman, Fox Systems
  • Dr. Julio Silva, Rush University Medical Center
  • Gwen Smith, HFS
  • Theresa Walunas, CHITREC
  • Matt Werner, Consultant
  • Laura Zaremba, OHIT

Review Minutes of Previous Meetings

The meeting minutes from the Feb. 3, Feb. 22, and March 3, 2011, meetings were approved by the group.

State Medicaid Health IT Plan (SMHP) Update

Renee Perry updated the group saying that HFS received additional guidance from the Centers for Medicare and Medicaid Services (CMS), and is incorporating changes into the SMHP. Renee indicated that she also participated in a Community of Practice conference call, with over 100 state agency participants regarding possible issues with states State Medicaid HIT Plans (SMHP) and Implementation Advance Planning Documents (IAPD). CMS identified several general concerns that should be addressed in each SMHP.

The themes identified were:

  • Calculation Information – The methodology, and data sources, for determining if the eligible provider practice is predominately a Federally Qualified Health Care clinic, Rural Health Clinic or a hospital-based clinic. There is no clear definition of the documents that states are required to collect to verify Adopt, Implement and Upgrade (AIU). At this point, Illinois is not planning to require any documentation. Renee is going to review other states' SMHPs to see if they require documentation.
  • No sample hospital incentive calculation included
  • Insufficient outreach to stakeholders at every level
  • No intermediate or administrative appeals step before the formal appeal process
  • Limited understanding of the impact of the Medicare and Medicaid Extenders Act of 2010
  • Failure to incorporate environmental scan results and how those results will impact the five-year plan
  • Lack of detail addressing how a managed care provider will get paid. This is for states that don't retroactively enroll their managed care providers.
  • Failure to address how the Medicaid agency will collaborate with the Regional Extension Centers (RECs)

There are three items that Illinois is addressing, which is the documentation for AIU, the impact of the Medicare/Medicaid Extenders Act and to make sure that the SMHP is clear on how the environmental scan will impact the five-year plan.

Renee discussed these questions with the regional CMS office, which indicated that they will give the SMHP a quick review when it's submitted. Renee will send an e-mail to the work group when the SMHP is submitted to CMS. HFS is on the same implementation timeline, and hopes to begin making initial payments in August 2011.

Hospital Incentive Payment Schedule

A spreadsheet was developed that indicates which hospitals have agreements with Health Maintenance Organizations. Frank Kopel reported that the latest spreadsheet indicates that no hospitals in Lake County have signed agreements, and that DuPage County has two out of eight hospitals with an agreement. Frank will find out if the spreadsheet can be shared with the work group. Mary McGinnis and Krysta Heaney are working on defining what the status is of hospitals implementing electronic medical records.

Address Scenarios for Provider Volume

Renee Perry said that she addressed the various scenarios in a document that she will e-mail to the work group.

Instructions for Provider Volume Calculation Worksheet

Renee Perry reported that the CMS presentation for the worksheet was not satisfactory and that she is adding more specific information to it. Renee will distribute the calculation worksheet to the group for review and asked that suggestions be e-mail to EHR Incentive.


Gwen Smith reported that she gave a presentation to the ILHIE Clinical Quality and Integration Work Group, and she will participate in future meetings with them. Gwen indicated that Illinois and Massachusetts are the only two states participating in the CHIPRA project that included in their proposal that they would develop new child health quality measures. Gwen will be attending a meeting at the end of April with the Agency for Healthcare Research and Quality and the pediatric measurement quality project principal investigators in Maryland. The meeting will cover how measures become measures and that they are evidenced based, validated and risk adjusted if needed. If work group members have any suggestions, please e-mail Gwen Smith.

Develop Agenda for Next Meeting

Renee Perry said that Meaningful Use education sessions are taking place. Ivan Handler said that it would be good to have someone with a clinical background at the sessions.

Agenda items identified for the next meeting are SMHP Update, Instructions and Identifying Testers for Provider Volume Calculation Sheet and CHIPRA.

The next meeting is scheduled on Monday, April 4, 2011. Meeting adjourned.